RAVEN JORDAN (NPI# 1083211544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083211544 |
| Entity Type | Individual |
| Full Name | RAVEN JORDAN |
| Credential | FNP |
| Practice Address |
215 N Allison Ave Barbourville KY 40906-1336 |
| Mailing Address |
18 Granger Ct Barbourville KY 40906-7212 |
| Practice Telephone | 6065469287 |
| Mailing Telephone | 6066274235 |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2020-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3015160 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
215 N ALLISON AVE |
| City | BARBOURVILLE |
| State | KY |
| Zip Code | 40906-1336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356327456 | William Thomas Ashburn | Family Medicine | 215 N Allison Ave, Barbourville, KY 40906-1336 | 2005-12-20 |
| 1386274850 | Cassie Renee Tye | Physician Assistant | 215 N Allison Ave, Barbourville, KY 40906-1336 | 2020-01-23 |
| 1619411782 | Susan Poff | Counselor | 215 N Allison Ave, Barbourville, KY 40906-1336 | 2016-12-08 |
| 1326422536 | Mary Ashburn | Counselor | 215 N Allison Ave, Barbourville, KY 40906-1336 | 2015-07-17 |
| 1982044616 | Stuart G Mack | Physician Assistant | 215 N Allison Ave, Barbourville, KY 40906-1336 | 2013-06-26 |
| 1023355237 | Matthew David Webb | Physician Assistant | 215 N Allison Ave, Barbourville, KY 40906-1336 | 2013-01-08 |
| 1619247913 | William H. Vickers, Od Pllc | Optometrist | 215 N Allison Ave, Barbourville, KY 40906-1336 | 2012-01-04 |
| 1780875666 | Lesley N Vaughn | Nurse Practitioner | 215 N Allison Ave, Barbourville, KY 40906-1336 | 2007-08-06 |
| 1356314199 | Stephen K Toadvine | Family Medicine | 215 N Allison Ave, Barbourville, KY 40906-1336 | 2006-02-10 |
| 1639155575 | Richard A Carter | Family Medicine | 215 N Allison Ave, Barbourville, KY 40906-1336 | 2005-12-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477187334 | Barbourville Prescription Center, LLC | Pharmacy | 1881 South U.S. Highway 25e, Barbourville, KY 40906 | 2020-02-28 |
| 1992368617 | Carolyn Disney Byble | Counselor | 1909 Hwy. 3439, Barbourville, KY 40906 | 2019-04-18 |
| 1386139111 | Amy Lynn Mills | Adult Companion | 12 Knox Plaza, Barbourville, KY 40906 | 2018-06-25 |
| 1457858250 | Angela Turner | Nurse Practitioner | 1927 Us S Hwy 25e, Barbourville, KY 40906 | 2018-04-09 |
| 1376049437 | Kalee Elizabeth Howard | Case Manager/Care Coordinator | 415 Highway 225, Barbourville, KY 40906 | 2018-04-05 |
| 1063949303 | Robin Renee Carr | Counselor | 415 Ky Hwy 225, Barbourville, KY 40906 | 2017-05-17 |
| 1770940736 | Jennifer Nicole James | Case Manager/Care Coordinator | 415 Ky 225, Barbourville, KY 40906 | 2016-01-21 |
| 1891116455 | Glenna Bargo | Nurse Practitioner | 728 S Us Highway 25e Loop Number 2, Loop Number 2, Barbourville, KY 40906 | 2013-12-30 |
| 1275883050 | Brian Keith Abner | Physician Assistant | 215 North Allison Avenue, Barbourville, KY 40906 | 2012-09-19 |
| 1558660944 | Sleep Diagnostics of Kentucky, Inc | Clinic/Center | 606a Knox Street, Barbourville, KY 40906 | 2011-03-24 |
| Find all providers in zip 40906 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104423383 | Heather Nicole Davis | Nurse Practitioner | 215 Treuhaft Blvd Ste 8, Barbourville, KY 40906-7361 | 2020-10-01 |
| 1942836796 | Diondra Warren | Nurse Practitioner | 104 Short St, Barbourville, KY 40906-1536 | 2020-03-12 |
| 1396378501 | Amanda Renee Lawson | Nurse Practitioner | 215 Treuhaft Blvd Ste 3b, Barbourville, KY 40906-7361 | 2020-02-16 |
| 1932663846 | Luvena Hensley | Nurse Practitioner | 2972 S Us Highway 25e, Barbourville, KY 40906-8105 | 2019-01-24 |
| 1548755499 | Thelma J Gray | Nurse Practitioner | 185 Treuhaft Blvd Ste 4, Barbourville, KY 40906-4090 | 2018-06-23 |
| 1891116455 | Glenna Bargo | Nurse Practitioner | 728 S Us Highway 25e Loop Number 2, Loop Number 2, Barbourville, KY 40906 | 2013-12-30 |
| 1881974418 | Donavan, Psc | Nurse Practitioner | 726 S Us Highway 25e, Barbourville, KY 40906-7316 | 2011-08-26 |
| 1942255245 | Keith Allen Everitt | Nurse Practitioner | 14 Knox Plz, Barbourville, KY 40906-7300 | 2006-05-24 |
| 1831167584 | Gina Good | Nurse Practitioner | 1927 S Hwy Us E, Barbourville, KY 40906-7300 | 2006-03-09 |
| 1821609173 | Brooklyn Prewitt | Nurse Practitioner | 1927 S Us Highway 25e, Barbourville, KY 40906-7600 | 2020-08-11 |
| Find all providers in BARBOURVILLE | ||||
| City | BARBOURVILLE |
| Zip Code | 40906 |
Please comment or provide details below to improve the information on RAVEN JORDAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.